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Surgical Case Reports

Fumihiro Terasaki, Yusuke Yamamoto, Katsuhisa Ohgi, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Katsuhiko Uesaka
BACKGROUND: A right-sided ligamentum teres (RSLT) is a rare congenital anomaly in which the fetal umbilical vein is connected to the right paramedian trunk. RSLT creates difficulty in liver resection with respect to decision-making regarding the resection line, deviation of the vasculobiliary architecture. We report a case in which laparoscopic left lateral sectionectomy (LLLS) was performed to treat colorectal liver metastasis (CRLM) in a patient with RSLT. CASE PRESENTATION: A 63-year-old man with a past history of rectal cancer presented to our institution due to liver metastasis in the left lateral section from rectal cancer...
March 15, 2019: Surgical Case Reports
Katelin Holmes, Joseph E Guinn
BACKGROUND: Amyand hernias have been described in case reports in the literature and are a rare occurrence in the career of a surgeon. Their management is even less well described and often poses problems in the management of repair due to concerns with contamination associated with appendectomy. Here, we describe a patient with an Amyand hernia seen on CT imaging preoperatively, who underwent appendectomy along with a lightweight mesh plug repair of his hernia. CASE PRESENTATION: An 88-year-old male presented with a right groin bulge and underwent preoperative imaging which indicated the presence of his appendix within his hernia...
March 15, 2019: Surgical Case Reports
Teijiro Hirashita, Yukio Iwashita, Hiroaki Nakanuma, Kazuhiro Tada, Kunihiro Saga, Takashi Masuda, Yuichi Endo, Masayuki Ohta, Toshifumi Matsumoto, Masafumi Inomata
BACKGROUND: Blood flow of the remnant stomach is supplied via the right gastric and right gastroepiploic vessels after proximal gastrectomy (PG). Whether the remnant stomach can be safely preserved in patients who undergo pylorus-preserving pancreatoduodenectomy (PPPD) after PG remains unclear. We herein report two cases in which the remnant stomach was safely preserved by performing PPPD. CASE PRESENTATION: The first patient, a 76-year-old man, was diagnosed with cancer of the common bile duct and underwent PPPD 2 years after PG for gastric cancer...
March 12, 2019: Surgical Case Reports
Yu Shomura, Toru Mizumoto, Kazuya Fujinaga, Yasuhiro Sawada, Hisato Ito, Satoshi Teranishi
BACKGROUND: Coronary artery aneurysm (CAA) is defined as dilatation exceeding 1.5 times the width of the normal adjacent coronary artery segments. CAA usually causes few symptoms, and rupture is rare, but can be lethal due to cardiac tamponade when it does occur. CASE PRESENTATION: A 79-year-old woman presented with presyncope and back pain. Emergency surgery was performed based on a diagnosis of cardiac tamponade due to either rupture of coronary arteriovenous fistula or CAA...
March 12, 2019: Surgical Case Reports
Takuya Nakayama, Miki Asano
BACKGROUND: The number of patients who require aortic valve replacement after coronary artery bypass grafting continues to increase. Re-operative cardiovascular surgery after coronary artery bypass grafting has various risk factors related to median re-sternotomy. It is particularly essential to avoid damage to the living graft. We successfully performed aortic valve replacement via right parasternal thoracotomy in a patient who had undergone coronary artery bypass grafting. CASE PRESENTATION: An 80-year-old man who had undergone coronary artery bypass grafting was referred to our hospital for syncope caused by severe aortic valve stenosis...
March 4, 2019: Surgical Case Reports
Musashi Takada, Takashi Okuyama, Ryuji Yoshioka, Tamaki Noie, Emiko Takeshita, Shinichi Sameshima, Masatoshi Oya
BACKGROUND: Intra-abdominal desmoid tumors are rare and generally occur in some patients with familial adenomatous polyposis or secondary to an external stimulus such as surgical trauma. We report herein a case of intra-abdominal desmoid tumor in the jejunal mesentery after laparoscopic colectomy for sigmoid colon cancer. CASE PRESENTATION: A 74-year-old woman underwent laparoscopic sigmoid colectomy for colon cancer with pathological stage I. Follow-up computed tomography (CT) 18 months after primary surgery showed a nodular and enhanced soft tissue density mass, 20 mm in size, in the mesentery at the left side of the abdomen...
February 28, 2019: Surgical Case Reports
Tetsuya Fukui, Yusuke Wakatsuki, Tadashi Matsukura
BACKGROUND: It is unclear whether simultaneous primary neoplasm resection and immunotherapy for advanced lung cancer is safe. We report a case of an elderly man with advanced lung cancer and myxofibrosarcoma. CASE PRESENTATION: The advanced lung cancer was treated with pembrolizumab, and partial response was achieved in 3 months. However, the mediastinal cyst enlarged rapidly. We resected the mediastinal tumor and diagnosed it as myxofibrosarcoma. The postoperative course was uneventful...
February 26, 2019: Surgical Case Reports
Daisuke Kurita, Takeo Fujita, Yasumasa Horikiri, Takuji Sato, Hisashi Fujiwara, Hiroyuki Daiko
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is a rare but life-threatening complication of early postoperative enteral feeding. We herein report two patients who developed NOMI during enteral feeding after esophagectomy. CASE PRESENTATION: In case 1, a 75-year-old man with no medical history was diagnosed with multiple primary cancers of the esophagus, stomach, and kidney. He underwent percutaneous endoscopic gastrostomy tube placement followed by thoracoscopic esophagectomy and cervical esophagostomy placement as the first-stage operation...
February 20, 2019: Surgical Case Reports
Makiko Mori, Haruru Kotani, Masataka Sawaki, Masaya Hattori, Akiyo Yoshimura, Naomi Gondo, Yayoi Adachi, Ayumi Kataoka, Kayoko Sugino, Nanae Horisawa, Mitsuo Terada, Yuri Ozaki, Hiroji Iwata
BACKGROUND: Amyloid tumor of the breast is a rare disease, which was first reported in 1973. To date, only six cases have been reported in Japan. CASE PRESENTATION: A 45-year-old woman who had a medical history of Sjogren's syndrome presented with a lump of 3 cm in diameter on the outer side of the right breast. Mammography showed no abnormality. Ultrasonography showed a well-defined and rough hypoechoic mass of 32 mm in diameter at the site of the lump. With suspicion of breast cancer, an ultrasound-guided vacuum-assisted breast biopsy was performed...
February 19, 2019: Surgical Case Reports
Nobuyuki Yoshiyasu, Fumitsugu Kojima, Yuya Ishikawa, Toru Bando
BACKGROUND: Among anterior mediastinal tumors, a teratoma is known to rupture with growth, but there have been few previous reports about thymoma rupture. We here report a rare case of an invasive thymoma with intrapulmonary and intrathoracic rupture requiring emergency life-saving surgery. To our knowledge, this is the first such case in the literature. CASE PRESENTATION: A 56-year-old woman suddenly experienced right precordial pain and hemoptysis. Enhanced computed tomography revealed a large mediastinal tumor pressing against the pulmonary hilar vascularity, with extravasation of blood into the right lung...
February 19, 2019: Surgical Case Reports
Jumpei Takamatsu
BACKGROUND: Simple pericardial injuries are asymptomatic in many cases and usually do not cause bleeding that leads to cardiac tamponade. In this study, however, we report a case involving a patient with pericardial injury, in whom extravasation in the pericardium was identified using contrast-enhanced computed tomography (CT). CASE PRESENTATION: A 67-year-old man fell from a 3-m-high ladder and was injured and transported to our hospital. No pericardial effusion was observed on focused assessment with sonography for trauma (FAST) or plain CT on arrival, but pericardial effusion was detected on follow-up observation...
February 19, 2019: Surgical Case Reports
Yasuto Sakaguchi, Teruya Komatsu, Yasutaka Takubo, Yasuji Terada
BACKGROUND: Spontaneous intracystic hemorrhage of cystic thymoma is very rare. We encountered a patient with giant cystic thymoma with spontaneous intracystic hemorrhage and successfully resected the thymoma. CASE PRESENTATION: A 38-year-old man was referred to our hospital with chest pain. Computed tomography revealed a uniform anterior mediastinum cystic mass. Two days after hospitalization, his chest pain worsened. Subsequent computed tomography showed that the tumor had become inhomogeneous...
February 19, 2019: Surgical Case Reports
Kenju Ko, Yasunori Nishida, Kotaro Sasahara, Hirofumi Kishimoto, Otagiri Noriaki, Katsunori Tauchi, Koji Azuhata, Kayoko Higuchi
BACKGROUND: Since intraductal tubulopapillary neoplasm (ITPN) is a rare disease, the clinical features of ITPN, especially the characteristics related to recurrence, have not been revealed. We performed a total remnant pancreatectomy for a patient whose ITPN recurred 16 months after pancreatoduodenectomy (PD). We report useful findings to clarify how ITPN reoccurs based on this experience and previously reported cases. CASE PRESENTATION: A 61-year-old male patient was diagnosed with pancreatic cancer and underwent PD...
February 19, 2019: Surgical Case Reports
Shota Mitsuboshi, Hideyuki Maeda, Masato Kanzaki
BACKGROUND: Hydrothorax due to pleuroperitoneal communication (PPC) is a rare complication of continuous ambulatory peritoneal dialysis (CAPD). Approximately 50% of the patients need to convert to hemodialysis. CASE PRESENTATION: A 65-year-old man with chronic renal failure due to membranoproliferative glomerulonephritis underwent CAPD. Seven months after starting CAPD, a chest X-ray showed a right hydrothorax. For performing radioscintigraphy, 99m Tc-macro-aggregated albumin was administered into the peritoneal cavity with dialysate, and a leakage point of the dialysate into the right pleural cavity was detected...
February 19, 2019: Surgical Case Reports
Takuji Sato, Takeo Fujita, Hisashi Fujiwara, Hiroyuki Daiko
BACKGROUND: Minimally invasive esophagectomy is considered a beneficial approach to esophageal cancer, although a hiatal hernia occurs more frequently in this approach than in open esophagectomy with reconstruction via the mediastinal route. Development of an internal hernia to the retrosternal space is not a recognized complication of reconstruction via the retrosternal route after esophagectomy. We herein report three cases of the development of an internal hernia to the retrosternal space after minimally invasive esophagectomy...
February 18, 2019: Surgical Case Reports
Makio Hayama, Seiji Yoshitomi, Maiko Tamura, Nobuhiko Ohnishi, Shigeharu Moriyama
BACKGROUND: Ectopic hamartomatous thymoma, which usually occurs in the lower neck, is a rare benign tumor containing spindle cells, epithelial nests, and adipose tissue. Although the origin of this tumor is still unknown, recent reports suggest that the designation of this tumor is inappropriate. CASE PRESENTATION: A 38-year-old with an anterior cervical mass in the suprasternal region of her neck was referred to our hospital. An ultrasound examination showed that the well-defined oval mass was 31 × 23 × 17 mm in size...
February 18, 2019: Surgical Case Reports
Toshinori Sueda, Mitsuyoshi Tei, Haruna Furukawa, Tae Matsumura, Chikato Koga, Masaki Wakasugi, Hiromichi Miyagaki, Ryohei Kawabata, Junzo Shimizu, Atsuya Okada, Junichi Hasegawa
BACKGROUND: A case of a short circuit (Retzius shunt) from the inferior mesenteric vein (IMV) to the inferior vena cava (IVC) without accompanying portal hypertension due to liver cirrhosis is rare. CASE PRESENTATION: An 83-year-old woman who was followed after surgery for thyroid and breast cancer was incidentally found to have rectal cancer on computed tomography (CT). Preoperative three-dimensional CT showed a venous malformation forming a short circuit (Retzius shunt) from the IMV to the IVC...
February 18, 2019: Surgical Case Reports
Hidemasa Kubo, Nobuki Yamaoka, Mizuki Tamai, Hajime Kamiya, Yosuke Kamada, Tomoyuki Nagata, Ken-Ichiro Fukuda, Eigo Otsuji
BACKGROUND: Polysplenia refers to the presence of two or more equal-sized spleens. Very rarely, one of the multiple spleens may develop torsion and infarction. CASE PRESENTATION: A 21-year-old woman presented with left upper quadrant pain, the cause of which could not be diagnosed. She returned to our hospital, 2 days later, without any pain improvement. Enhanced computed tomography showed splenic infarction and polysplenia. Initially, we could not identify the cause of the infarction and started conservative therapy, which did not result in any improvement...
February 18, 2019: Surgical Case Reports
Takumi Sonokawa, Takuma Matsui, Kyoshiro Takegahara, Tatsuya Inoue, Takeru Kashiwada, Yasuhiro Terasaki, Jitsuo Usuda
BACKGROUND: Pulmonary hematoma is most often caused by thoracic trauma. However, rare cases of pulmonary hematoma without any obvious cause are sometimes reported, when the condition is referred to as spontaneous or idiopathic pulmonary hematoma. Herein, we report a very rare case-to the best of our knowledge, this is the first case of pulmonary hematoma associated with diffuse pulmonary ossification requiring emergency treatment reported in the English literature. CASE PRESENTATION: Our patient was a 44-year-old man with a history of IgA nephropathy and had no history of trauma or anticoagulant use...
February 18, 2019: Surgical Case Reports
Masuyo Miyake, Akimitsu Yamada, Kentaro Miyake, Itaru Endo
BACKGROUND: The esophageal metastasis of breast cancer is rare. Moreover, it is extremely unusual for patients to experience the symptoms of esophageal metastasis during their lifetimes. We present a case of dysphagia caused by esophageal metastasis after a long interval following a primary mastectomy. CASE PRESENTATION: A 77-year-old woman with a history of heterochronous bilateral breast cancer and under treatment for pleural dissemination recurrence originating from right breast cancer complained of dysphagia...
February 15, 2019: Surgical Case Reports
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